Skin Concern2026-08-1812 min read

Pigmentation Concerns: Which Type Do You Have?

Pigmentation is not one condition. Sun-induced spots, melasma and post-inflammatory marks form through different mechanisms and sit at different depths — which is why one treatment does not resolve all of them.

Dr Sin Yong

MBBS (NUS, Singapore) · MRCS (Royal College of Surgeons, Edinburgh)
MSc Practical Dermatology (University of Cardiff, UK) · MSc Aesthetic Medicine (University of London)

In short

Pigmentation treatment in Singapore works when the type is identified first. Sun spots and freckles usually respond to pico or Q-switched laser. Melasma needs sun and heat control, creams such as azelaic acid or a supervised hydroquinone course, sometimes oral tranexamic acid, with low-energy laser toning in a supporting role. Marks after acne fade once the cause is settled. Settings are matched to Asian skin to avoid rebound darkening.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Updated 19 October 2026

On this page

Consultations in English and Mandarin (面诊可使用英语或华语). This page is also available in: 中文.

Key facts

Three main types: Sun spots and freckles, melasma, and post-inflammatory hyperpigmentation (PIH)
Depth: Epidermal pigment usually responds faster; dermal pigment is more persistent and needs energy that reaches it
Pico and Q-switched lasers: Very short pulses break pigment into fragments that the body clears; they do not bleach the skin
Melasma: Driven by UV, visible light, heat and hormones; managed over time and prone to recurrence
PIH risk: Skin types III–V, common in Singapore, can darken after over-aggressive settings, so energy is matched to skin type
Sun protection: Daily broad-spectrum sunscreen is part of every plan; without it, treated pigment tends to return
Creams: hydroquinone is a supervised, limited-course medicine in Singapore; azelaic acid, tranexamic acid and retinoids are alternatives
Consultation: S$120, waived with any medical treatment
Assessed by: Medical Director Dr Sin Yong at IN Eternity Clinic, 9 Scotts Road

East Asian woman in her thirties with even, natural skin tone in soft daylight, representing pigmentation treatment at IN Eternity Clinic, Singapore

Key points:

Pigment can sit in the epidermis (more treatment-responsive) or the dermis (more persistent)
Melasma is hormonally influenced and prone to recurrence — it is managed, not cured
Post-inflammatory hyperpigmentation can be triggered by treatment itself if settings are not matched to skin type

Why Pigmentation Is Not One Problem

Melanocytes overproduce pigment in response to several different triggers — UV exposure, inflammation, and hormonal signalling among them. Because the triggers differ, so does the appropriate response. A treatment that clears sun spots effectively may do little for melasma, and an overly aggressive approach can worsen pigmentation in melanin-rich skin by triggering a post-inflammatory response.

How Depth Changes the Answer

Epidermal pigment sits close to the surface and generally responds more readily. Dermal pigment sits deeper and needs energy that reaches that layer without excessive surface disruption. Assessment establishes which you have before any treatment is selected.

Treatments Used at IN Eternity Clinic

Depending on assessment, pigmentation may be addressed with pico laser for pigment fragmentation, R2 Glow Laser for brightening and toning, or a combined protocol. How each type is told apart is set out in pigmentation types explained.

What Matters More Than the Device

Fitzpatrick skin type directly changes which settings are safe and effective. In a population spanning a wide range of skin tones, matching the wavelength and energy to your specific skin is what separates a good outcome from a worsened one.

“Melasma is managed, not erased. A plan that promises to clear it for good has misread what melasma is.”

— Dr Sin Yong, Medical Director, IN Eternity Clinic

Frequently Asked Questions

Can pigmentation be permanently removed?+

Sun-induced pigmentation often responds well and can stay clear with sun protection. Melasma is hormonally influenced and tends to recur, so it is managed over time rather than permanently resolved.

Why did my pigmentation worsen after treatment?+

This can occur when treatment triggers inflammation, which can cause post-inflammatory hyperpigmentation — a particular risk in melanin-rich skin when settings are not appropriately calibrated.

How many sessions are needed?+

This depends on pigment type, depth and severity, and is reviewed as treatment progresses rather than fixed at the outset.

Why does pigmentation seem worse in Singapore?+

Year-round UV, strong visible light and heat all stimulate pigment cells, and heat in particular aggravates melasma. Many people in Singapore also have skin types III to V, which react to inflammation with more pigment. Sun protection, heat avoidance and settings matched to skin type matter as much as the device.

Can pigmentation be treated during pregnancy?+

Most laser and prescription pigment treatment is postponed until after pregnancy and breastfeeding. Pregnancy often darkens melasma, and some of that settles afterwards. In the meantime, sun protection and pregnancy-safe skincare are used, and the plan is reassessed after delivery.

Does pigmentation come back after laser?+

It depends on the type. A treated sun spot does not usually return in the same place, though new spots can form with sun exposure. Melasma tends to recur, especially with heat and hormones, so it needs maintenance. Post-inflammatory marks fade once the inflammation that caused them is controlled.

Find your pigment

Which type of pigmentation do I have?

Type	Typical clues	Read more
Sun spots / age spots (solar lentigines)	Sharp edges, stable all year, on sun-exposed skin	Sun spots and age spots
Freckles (ephelides)	Small, since childhood, darker in sun and lighter without it	Freckles
Melasma	Symmetrical patches on cheeks, forehead or upper lip; worse with hormones and heat	Melasma
Post-inflammatory marks	Follow acne, a burn, friction or a procedure	Post-inflammatory pigmentation
Dark lips	Diffuse or patchy darkening of the lips	Lip pigmentation
Dark underarms	Linked to friction, shaving or hair-removal habits; occasionally a medical sign	Underarm pigmentation

A single spot that is new, changing, irregular in colour or border, or different from the rest is examined before any cosmetic treatment. Pigmented moles are covered on the mole removal page, and every pigment type is explained in plain language on the conditions index.

By type

Pigmentation treatment by type: what usually works for each

Each type of pigment has its own first step. The table links to the page that covers each one in detail.

Typical courses vary with depth, skin type and how well triggers are controlled.
Type	First step	In-clinic options at IN Eternity Clinic	Typical course	Read more
Sun spots and age spots	Daily sunscreen; check any spot that looks different	Picosecond or Q-switched laser (Fotona StarWalker PQX, DEKA TORO)	Often one to a few sessions	Age spot removal
Freckles	Sun protection, because the tendency is genetic	Pico or Q-switched laser	Few sessions; new freckles appear with sun	Freckles
Melasma	Sun, visible-light and heat control; trigger review	Topical plan, oral tranexamic acid after a clotting review, cautious low-fluence laser toning	Months, then maintenance	Melasma treatment
Post-inflammatory marks	Treat the acne, rash or irritation causing them	Topicals, gentle toning or peels once the skin is calm	Weeks to months	Acne marks and PIH
Dark lips	Consider sun, smoking, friction and medicines	Pigment laser at settings for lip skin	Several sessions	Lip pigmentation
Dark underarms	Reduce friction, shaving and irritation	Laser and topical care after assessment	Several sessions	Underarm pigmentation

Methods compared

Pico laser, laser toning, peels or creams: how they differ

The four main tools work at different depths and speeds. Most plans use more than one, in sequence.

Methods and settings are chosen after assessment. Prescription medicines are prescribed only after assessment.
Method	How it works	Suits	Downtime	At IN Eternity Clinic
Picosecond laser	Ultra-short pulses shatter pigment mainly by pressure, with little heat	Discrete spots, freckles, deeper pigment, tattoo ink	Small dark crusts for about a week on treated spots	Laser for pigmentation in Singapore
Low-fluence laser toning	Gentle 1064 nm Q-switched passes repeated across a course	Diffuse uneven tone; cautious support in melasma	Usually a few hours of redness	Laser toning
Chemical peels	Controlled exfoliation that sheds surface pigment	Superficial pigment, dullness, some acne marks	Flaking for a few days, depending on depth	Chemical peels
Creams	Slow pigment production (hydroquinone, azelaic acid, tranexamic acid, retinoids)	Melasma, post-inflammatory marks, maintenance	Possible dryness or irritation	When creams stop working
Oral tranexamic acid	Acts on vascular and inflammatory signals that drive melasma	Stubborn melasma	None; it is a prescription medicine with a clotting-risk review	Melasma options compared

The order matters as much as the choice. Melasma treated with strong laser alone often rebounds darker, while a sun spot treated with creams alone barely changes. The detailed comparison of pulse types is in pico vs Q-switched vs laser toning.

A woman and a doctor looking together at a printed skin plan during a pigmentation consultation, both heads fully in frame — Illustrative image. Not a patient of IN Eternity Clinic.

Creams

Hydroquinone and other creams: where they fit

Creams act on how much pigment is made in the upper skin, so they suit melasma and post-inflammatory marks better than discrete spots. Hydroquinone is the most studied; in Singapore, HSA treats it as a potent ingredient of prescription medicines that is prohibited in cosmetic skincare and should only be used under strict medical supervision. It is used in limited courses, because long unsupervised use can cause a blue-grey darkening called ochronosis.

Azelaic acid, tranexamic acid, cysteamine, retinoids and niacinamide are alternatives or maintenance options. The medical options for melasma are compared in melasma: laser vs tranexamic acid vs skincare, and if a cream has stopped working, when pigmentation creams stop working explains the usual reasons.

Treatments

Pigmentation treatments used at IN Eternity Clinic

Pico laser for pigmentation explains how picosecond pulses break pigment mainly by pressure rather than heat, and which spots suit it. IN Eternity Clinic uses two picosecond platforms: the Fotona StarWalker PQX (the R2 Glow protocol) and the DEKA TORO (T2 Frax Radiance, which pairs pigment pulses with a thermal pulse aimed at collagen).

Laser toning uses low-fluence 1064 nm Q-switched Nd:YAG repeated over a course, for diffuse uneven tone and, cautiously, as part of melasma care. Melasma treatment covers the medical side, including oral tranexamic acid (a prescription medicine) after a review of clotting risk. Chemical peels suit some superficial pigment and dullness, and the Luminescence Laser Lift is used where tone and texture are treated together. Tattoo ink, including old brow embroidery, is handled separately on tattoo removal; new brows are covered on eyebrow embroidery.

Compare

Comparisons and guides for pigmentation

If you are weighing options, these guides set out the trade-offs plainly: pico vs Q-switched vs laser toning, melasma: laser vs tranexamic acid vs skincare, laser toning vs chemical peel and PicoSure vs PicoWay vs StarWalker.

For the wider picture, read pigmentation types explained, the melasma guide, when pigmentation creams stop working and what affects pico laser pricing.

Skin type and climate

Darker skin, hormones and Singapore sun

Pigment cells in darker skin react more readily to heat and injury, so settings are matched to Fitzpatrick type; laser care for darker skin tones explains test spots and wavelength choice. Year-round UV and heat in Singapore keep melasma active, which is why sun and heat control is part of every plan (Singapore climate and your skin). Pigment that appeared during pregnancy is covered in the after-pregnancy hub, and what can be treated while pregnant or breastfeeding is on the pregnancy and breastfeeding safety page.

Sessions and recovery

How many sessions, and what recovery looks like

Sun spots: often clear or lighten noticeably over one to a few laser sessions; each treated spot darkens and flakes over about a week.
Freckles: lighten over a few sessions; they return with sun because the tendency is inherited.
Melasma: improvement is measured over months, combining creams, sun and heat control and sometimes oral medication, with gentle laser toning at intervals. Maintenance continues.
Post-inflammatory marks: fade over weeks to months once the cause is controlled; gentle treatment can speed this, aggressive treatment can prolong it.

Progress is reviewed on photographs in the same light. Daily broad-spectrum sunscreen is part of every plan; in Singapore’s year-round UV, treated pigment without sun protection tends to come back.

At assessment

What Dr Sin Yong looks for

The pattern. Symmetrical patches on the cheeks, forehead or upper lip suggest melasma; sharp-edged spots on sun-exposed skin suggest sun spots; marks in the place of old acne suggest post-inflammatory pigment.
The depth. Brown pigment tends to be near the surface; grey-blue suggests deeper pigment, which changes the method and the number of sessions.
Skin type and past reactions. Previous darkening after laser, peels or waxing means gentler settings and test spots.
Triggers still running. Daily sun exposure, heat at work or exercise, hormonal contraception, pregnancy plans.
What has been applied. Prescription and online lightening creams, including how long they were used.
Any spot that looks different. A new, changing or irregular spot is examined before any cosmetic treatment.

General clinical observations used at consultation; they describe what is checked, not any individual result.

When this is not cosmetic

When pigmentation is not cosmetic: signs to have checked

Most pigmentation is harmless. These signs need a medical assessment first, and sometimes a biopsy.

A spot that is new, changing, irregular in shape or colour, bleeding or itching, or one that looks unlike your other spots: it is examined before any laser, which could otherwise hide the signs.
A new dark streak in a fingernail or toenail: seen by a doctor promptly.
Velvety darkening of the neck, armpits or groin: possible acanthosis nigricans, linked to insulin resistance; investigated rather than lightened.
Generalised darkening of the skin or gums with tiredness, weight loss or dizziness: a hormonal cause is ruled out by a doctor.
Pigment that appeared after starting a new medicine: reviewed with the prescribing doctor.
Blue-grey or speckled darkening after long use of a lightening cream: possible ochronosis; the cream is stopped.

Where any of these apply, a diagnosis comes first; cosmetic treatment can follow once the cause is clear.

A woman in her thirties in a wide-brimmed hat walking under shady trees on a bright Singapore morning, her whole head and face in frame — Illustrative image. Not a patient of IN Eternity Clinic.

Cost

How much does pigmentation treatment cost in Singapore?

Cost depends on the type of pigment, the area, the methods used and how many sessions and maintenance visits are needed. A few sun spots and a long-standing melasma plan are very different undertakings. What drives the total is set out in pigmentation removal cost in Singapore; at IN Eternity Clinic the plan and its cost are given after assessment, and the consultation fee of S$120 is waived with any medical treatment.

Questions

Book an assessment

IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. The consultation fee is waived with any medical treatment.

WhatsApp to Enquire →Call +65 8815 3008

References

Sheth VM, Pandya AG. Melasma: a comprehensive update: part I. J Am Acad Dermatol 2011;65(4):689-697. doi:10.1016/j.jaad.2010.12.046
Kasai K. Picosecond Laser Treatment for Tattoos and Benign Cutaneous Pigmented Lesions (Secondary publication). Laser Ther 2017;26(4):274-281. doi:10.5978/islsm.17-RE-02
Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol 2010;3(7):20-31. PMID 20725554
Wattanakrai P, Mornchan R, Eimpunth S. Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians. Dermatol Surg 2010;36(1):76-87. doi:10.1111/j.1524-4725.2009.01383.x
Passeron T, Picardo M. Melasma, a photoaging disorder. Pigment Cell Melanoma Res 2018;31(4):461-465. doi:10.1111/pcmr.12684
Ho SGY, Chan HHL. The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases. Am J Clin Dermatol 2009;10(3):153-168. doi:10.2165/00128071-200910030-00002
Sheth VM, Pandya AG. Melasma: a comprehensive update: part II. J Am Acad Dermatol 2011;65(4):699-714. doi:10.1016/j.jaad.2011.06.001
Taraz M, Niknam S, Ehsani AH. Tranexamic acid in treatment of melasma: a comprehensive review of clinical studies. Dermatol Ther 2017;30(3):e12465. doi:10.1111/dth.12465
Health Sciences Authority. HSA alert: 18 cosmetic products detected to contain potent undeclared ingredients including high levels of mercury (20 April 2018). States that hydroquinone and tretinoin are potent ingredients used in prescription medicines, are prohibited in skincare cosmetic products and should only be used under strict medical supervision. hsa.gov.sg
Singapore Medical Council. Guidelines on Aesthetic Practices for Doctors (2016 edition). healthprofessionals.gov.sg/smc

These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.